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PY3 > Colon Cancer > Flashcards

Colon Cancer Flashcards

1
Q

What are the 6 risk factors for colon cancer?

A
  1. Age
  2. African American race
  3. Genetic predisposition
  4. Other GI conditions
  5. Diet
  6. Physical inactivity
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2
Q

What is the best type of prevention for colon cancer?

A

Lifestyle modifications

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3
Q

What are the 3 lifestyle modifications that can be used in colon cancer?

A
  1. Diet
  2. Physical activity
  3. Limit alcohol consumption
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4
Q

What drug is FDA approved to decrease the number of polyps in patients with familial adenomatosis polyposis?

A

Celecoxib

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5
Q

What patient population is aspirin reserved in?

A

Cardiovascular disease prevention

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6
Q

What are 4 screening tests used for colon cancer?

A
  1. Endoscopy (colonoscopy)
  2. Stool DNA test
  3. Fecal occupant blood test
  4. Digital rectal exam
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7
Q

What age should patients with average risk get screened?

A

After age 45

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8
Q

When should a patient get a colonoscopy if they are average risk?

A

Every 10 years

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9
Q

When should a patient get a flexible sigmoidoscopy if they are average risk?

A

Every 5 years

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10
Q

When should a patient get a stool DNA test if they are average risk?

A

Every 1-3 years

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11
Q

What are 5 signs and symptoms of colon cancer?

A
  1. Change in bowel habits
  2. Diarrhea or constipation
  3. Blood in the stool
  4. Anorexia
  5. Abdominal pain/ fullness
  6. Weight loss
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12
Q

What are the 3 main sites of metastases?

A
  1. Brain
  2. Liver
  3. Lungs
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13
Q

For diagnosis what is required?

A

A biopsy

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14
Q

After colon cancer is confirmed, what do patients have to do?

A

Go through staging scans to determine if disease is already metastatic

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15
Q

For stage I treatment, surgery is followed by what?

A

Surveillance

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16
Q

True or false: adjuvant therapy can be given to stage I colon cancer patients

A

False

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17
Q

When can adjuvant chemotherapy be used in stage II?

A

If patient has poor prognostic factors

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18
Q

What are 2 poor prognostic factors that can be used to determine therapy?

A
  1. Larger tumor
  2. Lymphovascular invasion
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19
Q

Chemotherapy for colon cancer is _____ based

A

5-FU

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20
Q

How long is a patient on adjuvant therapy for in stage III?

A

6 months

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21
Q

What is the 1st line chemotherapy regimen for stage III colon cancer?

A

FOLFOX

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22
Q

What is the oral equivalent to FOLFOX?

A

CapeOx

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23
Q

What does 5-FU inhibit?

A

Thymidylate synthase

24
Q

What drug helps to increase 5-FU activity?

A

Leucovorin

25
Q

What are the 5 toxicities that can be caused by 5-FU?

A
  1. Myelosuppression
  2. Hand-foot syndrome
  3. Diarrhea
  4. Mucositis
  5. N/V
26
Q

How is 5-FU administered?

27
Q

What drug is the prodrug of 5-FU?

A

Capecitabine

28
Q

How is capecitabine administered?

29
Q

What is the MOA of oxaliplatin?

A

Cross linking of DNA to cause double-stranded breaks

30
Q

What is the main toxicity of oxaliplatin?

A

Neuropathy

31
Q

What is neuropathy exacerbated by?

A

Cold temperatures

32
Q

What is the goal of therapy for stage IV colon cancer?

A

Palliative care

33
Q

When can surgery be considered for stage IV colon cancer?

A

If there is bowel obstruction

34
Q

What is the best treatment option for stage IV colon cancer?

A

Chemotherapy

35
Q

What does FOLFIRI consist of? 3

A
  1. 5-FU
  2. Leucovorin
  3. Irinotecan
36
Q

What does irinotecan inhibit?

A

Topoisomerase I

37
Q

What is the main toxicity for irinotecan?

38
Q

What should you base the choosing of a regimen on for stage IV colon cancer?

A

Expected tolerability

39
Q

What are the 3 drugs that are in the FOLFOX regimen?

A
  1. 5-FU
  2. Leucovorin
  3. Oxaliplatin
40
Q

What two monoclonal antibody inhibitors can be used in stage IV?

A
  1. VEGF inhibitors
  2. EGFR inhibitors
41
Q

What does VEGF promote?

A

Angiogenesis

42
Q

What 3 things does blocking VEGF cause?

A
  1. Inhibition of tumor angiogenesis
  2. Normalization of tumor vasculature
  3. Facilitation of chemotherapy delivery to tumor site
43
Q

Bevacizumab

44
Q

What are 5 ADEs of avastin?

A
  1. Hypertension
  2. Proteinuria
  3. Would healing complications
  4. Thromboembolic events
  5. GI perforation
45
Q

What is avastin only indicated for?

A

Metastatic colon cancer

46
Q

What can bevacizumab be used in combination with?

A

5-FU based chemotherapy

47
Q

What type of KRAS gene would have a good response to anti-EGFR therapies?

A

KRAS wild type

48
Q

What does using an EGFR inhibitor cause? 3

A
  1. Inhibits cell growth
  2. Promotes apoptosis
  3. Decreases production of growth factors
49
Q

Cetuximab

50
Q

What are 4 ADEs of cetuximab?

A
  1. Infusion related reactions
  2. Acne form rash
  3. Hypomagnesemia
  4. Diarrhea
51
Q

Panitumumab

52
Q

_______ has no role in colon cancer

53
Q

What is the treatment for stage I?

A

Surgery alone

54
Q

What is the preferred regimen for stage III?

55
Q

What are the 2 EGFR inhibitors?

A
  1. Cetuximab
  2. Panitumumab
56
Q

Switching for what inhibitors are not recommended?

PY3 (24 decks)

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